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DISTRICT OF COLUMBIA Annual Domicile Report Published by the Captive Insurance Council of the District of Columbia The DC Difference... Solutions | Accessibility | Leadership 1250 H Street, NW | Suite 901 | Washington, DC 20005 | 202.463.8163 | www.dccaptives.org The DC Difference... Solutions | Accessibility | Leadership
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Page 1: Annual Domicile Report - Council of the District of Columbia · AnnuAl Domicile RepoRt 3 “We had a choice on where to domicile our risk retention group and selected DC based on

District of columbiaAnnual Domicile Report

Published by the

Captive Insurance Councilof the District of Columbia

The DC Difference...Solutions | Accessibility | Leadership

1250 H Street, NW | Suite 901 | Washington, DC 20005 | 202.463.8163 | www.dccaptives.org

The DC Difference...Solutions | Accessibility | Leadership

Page 2: Annual Domicile Report - Council of the District of Columbia · AnnuAl Domicile RepoRt 3 “We had a choice on where to domicile our risk retention group and selected DC based on
Page 3: Annual Domicile Report - Council of the District of Columbia · AnnuAl Domicile RepoRt 3 “We had a choice on where to domicile our risk retention group and selected DC based on

AnnuAl Domicile RepoRt 3

“We had a choice on where to domicile our risk retention group and selected DC based on its favorable regulatory environment. Our experience has been further enhanced through our involvement with CIC-DC, which has helped keep us connected with the regulators and key service providers.”

Jim CaldwellPresident, Caring Communities, RRG

“Our organization’s risk management program is very sophisticated and its essential that we are able to operate in a regulatory environment that recognizes the need for progressive risk management solutions. The captive regulators in DC have consistently demonstrated a solid understanding of our business model.”

Larry SmithVice President

Risk Management

“When DC became a captive domicile, we realized that it offered numerous unique advantages, so we took action to re-domesticate our captive here and have never regretted that decision.”

Dixie ArthurPresident, ASAE Services Corp.

“Based on our positive experience, I would highly recommend the District to anyone considering where to domicile their captive. You simply can’t go wrong doing business in what is arguably the most prestigious city in the world.”

Keith GibbPresident, AEGIS Health Care RRG

reputation

What others have to say about the DC Difference...

Page 4: Annual Domicile Report - Council of the District of Columbia · AnnuAl Domicile RepoRt 3 “We had a choice on where to domicile our risk retention group and selected DC based on

4 AnnuAl Domicile RepoRt

Organizations look to captives to provide risk management solutions for many different reasons.

Stabilize & Reduce cost of Risk Financing corporate risks through a captive insurance company often reduces overall costs immediately and helps stabilize costs over the long-term because organizations are less susceptible to the vagaries of the traditional insurance market.

increased capacity and provide Direct Access to Reinsurance By being able to access the reinsurance market directly, captive insurance companies can save money on the cost of reinsurance while increasing their capacity to underwrite risk.

Better coverage options Captives can provide coverage to business entities that would not otherwise be available. Such coverages often include: punitive damages, professional liability and specialized business risks.

investment income and cash Flow Investment income that would otherwise be earned by commercial insurance carriers is retained by the captive, thereby facilitating better cash flow.

tax considerations While industry experts agree that a captive should not be formed solely for tax reasons, there are tax benefits nonetheless. Deductibility of premiums and deferred taxation of insurance income are two significant advantages of forming a captive.

captive aDvantages

Page 5: Annual Domicile Report - Council of the District of Columbia · AnnuAl Domicile RepoRt 3 “We had a choice on where to domicile our risk retention group and selected DC based on

AnnuAl Domicile RepoRt 5

captive aDvantages

Why a Washington, Dc captive?

• Any type of captive, including risk retention groups, may create one or more protected cells. Captives also have the option of establishing protected cells as separate legal entities.

• A modern, progressive captive insurance law that meets the demands of the marketplace and is responsive to current market trends.

• Parity provision will permit a captive to engage in any type of business in Washington that is permitted in any other captive jurisdiction (on-shore or off-shore)

• Experienced and dedicated staff committed to working with risk managers and business owners to provide creative solutions to your risk financing needs.

• Established network of legal, accounting, actuarial, captive management and investment professionals with extensive experience establishing and managing captive insurance businesses.

• A leading jurisdiction in the United States to permit Incorporated Cells. No sponsor is required for cell companies.

• A flexible investment law which enables captives to maximize investment return.

• The minimum capital required is only $100,000 for all types of captives.

• A revitalized capital city experiencing a growth and cultural renaissance, making it one of the world’s most attractive business destinations.

The District of Columbia has developed a

well-earned reputation of keeping its captive law current and

responsive to industry developments.

Page 6: Annual Domicile Report - Council of the District of Columbia · AnnuAl Domicile RepoRt 3 “We had a choice on where to domicile our risk retention group and selected DC based on

6 AnnuAl Domicile RepoRt

Dc captive law requirements

types of captives Allowed• Agency

• Association

• Branch

• Pure

• Protected Cell

• Rental

Acceptable corporate Forms• Stock

• Mutual

• Reciprocal

• Limited Liability

• Companies

• Both For Profit and Non-Profit Entities are permitted

minimum capital Requirements• $100,000 regardless of form of ownership

• Minimum capital must be in the form of either cash or letter of credit

minimum Surplus Requirements• Agency Captives - $300,00

• Association Captives (Stock) - $300,000

• Association Captives (Mutual or Reciprocal) - $500,000

• Pure Captives - $150,000

• Rental Captives - $300,000

types of Direct insurance permitted• All types of insurance except direct personal lines and

workers’ compensation

• May also offer excess workers’ compensation insurance to parents/affiliates

Reinsurance• May take credit for risks ceded to any reinsurance

approved by the commissioner

• May assume risk from other insurers

investment limitations• A captive may invest its assets in any investment

approved by the Commissioner

minimum premium Amount• None

Page 7: Annual Domicile Report - Council of the District of Columbia · AnnuAl Domicile RepoRt 3 “We had a choice on where to domicile our risk retention group and selected DC based on

AnnuAl Domicile RepoRt 7

Dc captive law requirements

premium tax Rates

Direct Reinsurance Risk Retention Groups

First $25 million: 0.250% 0.225% First $20 million: 0.380%

$25-$50 million: 0.150% 0.150% $20-$40 million: 0.250%

Over $50 million: 0.050% 0.25% Over $40 million: 0.180%

Minimum Tax – $7,500 Minimum Tax – $15,000

Maximum Tax – $100,000 Maximum Tax – $100,000

Application Requirements• A completed signed application

• A business plan summary

• An actuarial feasibility study

• Articles, bylaws, participation or shareholders agreements

• Captive manager and other service provider agreements

• A description of the risk management program

• A description of the underwriting and claims administration process

• Five-Year financial pro forma showing expected and adverse scenarios

• Biographical affidavits for all officers, directors and key service providers

• A non-refundable application fee ($500) and certificate of authority fee ($300)

Financial Reporting Requirements• Non-risk retention groups must file annual unaudited

financials on DC form on GAAP basis

• Risk Retention groups must file annual and quarterly unaudited financials on National Association of Insurance Commissioners (NAIC) Yellow Blank on GAAP basis

• All captives must file annual audited financials and actuarial certification of loss reserves

other Requirements• Captive must retain qualified manager, attorney,

accountant and actuary

• Captive must hold annual board of directors meeting in DC

Page 8: Annual Domicile Report - Council of the District of Columbia · AnnuAl Domicile RepoRt 3 “We had a choice on where to domicile our risk retention group and selected DC based on

8 AnnuAl Domicile RepoRt

Alternative Markets Division

Great American Insurance Group I 301 E Fourth Street I Cincinnati, OH 45202

Alignment of interest and a common goal. When every stroke counts, trust in Great American’s risk-sharing expertise and unparalleled commitment to building long-term, profitable captive relationships.Every customer. Every account. Every time.

Pulling together.

Page 9: Annual Domicile Report - Council of the District of Columbia · AnnuAl Domicile RepoRt 3 “We had a choice on where to domicile our risk retention group and selected DC based on

AnnuAl Domicile RepoRt 9

Alternative Markets Division

Great American Insurance Group I 301 E Fourth Street I Cincinnati, OH 45202

Alignment of interest and a common goal. When every stroke counts, trust in Great American’s risk-sharing expertise and unparalleled commitment to building long-term, profitable captive relationships.Every customer. Every account. Every time.

Pulling together.

Page 10: Annual Domicile Report - Council of the District of Columbia · AnnuAl Domicile RepoRt 3 “We had a choice on where to domicile our risk retention group and selected DC based on

10 AnnuAl Domicile RepoRt

programs

Active DC Captive ProgramsAARP Andrus Insurance Fund, LLC

Aegis HealthCare Risk Retention Group, Inc.

AEW Reinsurance Company

Ag States Reinsurance Company, IC

Akros Insurance, LLC

American Staffing Assurance Company of Washington, DC,1C

Andie Indemnity, Inc.

Argus Insurance Group, Inc.

ASAC, Inc., PCC

ASAE Insurance Company, IC, AOP-01

ASAE Insurance Company, IC, DO-02

ASAE Insurance Company, Inc.

Association Mutual Health Insurance Company

*AssureCare Corporation

Attorneys Insurance Mutual of the South, Inc., Risk Retention Group

AttPro RRG Reciprocal Risk Retention Group

AVR-Crossroads Captive Insurance Company

Bancroft Insurance Group PCC, Inc.

Bexar Assurance PCC

Big I Reinsurance Company (BIRC)

Biltmore Insurance Company, PCC

Binyan Insurance Company

BMC Community Physician Program Risk Retention Group, Inc.

Brewster Indemnity, IC

Capital Risk Alternatives PCC, LLC

Capitol Risk & Indemnity Company, Inc.

Care Risk Retention Group, Inc.

Caring Communities, A Reciprocal Risk Retention Group

Centurion Re. Inc.

Charleston Capital Reinsurance, LLC

Chesapeake Bay Insurance Company

Chesapeake Bay Insured Participation Segregated Cell

CMIC RRG

Consolidated American Rental Insurance Company, Ltd.

Coverys RRG, Inc.

Crown Captive Insurance Company Inc.

CTIA Indemnity Company, LLC

C-U First, LTD

Defense Shield Insurance Company, Inc.

Devonshire Underwriters, Ltd.

District of Columbia Medical Liability Captive Insurance Agency

DSG Imaging, Inc. IC

Dubois Medical Risk Retention Group

Equity Assurance Company

F P Indemnity, Inc.

Fairway Physicians Insurance Company, A Risk Retention Group

Five Star Assurance, Inc.

Franklin Property and Casualty, Inc.

General International (US) Limited

Global International Insurance Company, Inc., A Risk Retention Group

Government Entities Mutual, Inc., PCC

Greenwich Global Insurance IC

Health Network Providers Mutual Insurance Company, A Risk Retention Group

Health Care Casualty Risk Retention Group, Inc.

Health Care Industry Liability Reciprocal Insurance Company, A Risk Retention Group (HealthCap RRG)

Membership in Caring Communities represents a strategic opportunity for preferred not-for-profit Senior Housing Community Care and Service Providers to be the owners and policyholders for the company that provides their professional, general and excess liability insurance protection. Members of Caring Communities “invest in” and “own” their risks exclusively with other Senior Community Care and Service Providers. They all know one another; they have common interests, commitments and incentives – and thereby are directly rewarded by sharing in the profits of the company based on performance (with the greater share going to the best performers). Members work together to provide the safest environments and practices for their residents, people in their care and their employees. To learn more about Caring Communities, contact: Ashur Odishoo, National Director Sales and Marketing 1-800-510-8225, [email protected] www.caringcomm.org

Page 11: Annual Domicile Report - Council of the District of Columbia · AnnuAl Domicile RepoRt 3 “We had a choice on where to domicile our risk retention group and selected DC based on

AnnuAl Domicile RepoRt 11

Heartland Fidelity Insurance Company

Heavy Equipment Operators Captive Insurance Company

Impact Risk Funding, Inc., PCC

Intermodal Insurance Company, A Risk Retention Group

JELCO Cell A, IC

JELCO Cell B, IC

JELCO Cell C, IC

JELCO Cell D, IC

JELCO Insurance Company, PCC

Kirtland Healthcare Cell Company, IC

Liberty IC Casualty II LLC

Liberty IC Casualty LLC

Lions Insurance Company

Louis Indemnity, Inc.

Mangrove Cell 1 PC

Mangrove Cell 2 PC

Mangrove Insurance Solutions, PCC

Martin Indemnity, Inc.

MedPro RRG Risk Retention Group

MedStar Liability Limited Insurance Company, Inc. A Risk Retention Group

MMIC RRG, Inc.

NASW Insurance Company

National Assisted Living Risk Retention Group, Inc.

National Service Contract Insurance Company Risk Retention Group, Inc.

NationsBuilders Insurance Company

New Home Warranty Insurance Company, A Risk Retention Group

New York Healthcare Insurance Company, Inc., A Risk Retention Group

NJ CAR Risk Retention Group

Northern Lights Insurance Company, PCC

Ocean Risk Retention Group, Inc.

Passenger Railroad Insurance, Ltd.

PCH Mutual Insurance Company, Inc., A Risk Retention Group

Pediatricians Insurance Risk Retention Group of America, Inc.

Pinelands Insurance Company Risk Retention Group, Inc.

Pinnacle Risk Retention Group, Inc.

Pleiades Insurance Company, Ltd.

Port Authority Insurance Captive Entity, LLC

Preferred Managed Risk, LTD.

Preservation Insurance PCC, LLC

ProBuilders Specialty Insurance Company, RRG

Procentury Risk Partners Insurance Company

Red Cedar Insurance Company

Regional Health Insurance Company, A Risk Retention Group

Saber Cell Company, IC

Scaffold Industry Insurance Company Risk Retention Group, Inc.

Select Providers Insurance Reciprocal Exchange, A Risk Retention Group

Sigma Risk Retention Group, Inc.

Somerset Casualty, Inc.

Spirit Mountain Insurance Company Risk Retention Group, Inc.

Target Markets Mutual Insurance Company, IC

TDC Special Risks Insurance Company

The NAMG Insurance Company

Transportation Trucking Insurance Company, Inc.

**Trinity Risk Solutions Reciprocal Insurance Company, A Risk Retention Group

ULLICO Captive PCC

United Methodist Property and Casualty Trust

Virginia Senior Care Risk Retention Group

VSC Re Company

Note: *Converted from a RRG to a Regular Captive **109. Name Change: Formerly Known as Life Services Nework Reciprocal Ins. Co. (LSN), A RRG

Page 12: Annual Domicile Report - Council of the District of Columbia · AnnuAl Domicile RepoRt 3 “We had a choice on where to domicile our risk retention group and selected DC based on

12 AnnuAl Domicile RepoRt

members

AARp 601 E. Street N.W., A8-100 Washington, DC 20049

Aon Risk Services 1 Poston Road, Suite 155 Charleston, SC 29407

ASAe Services, inc. 1575 I Street, N.W. Washington, DC 20005

Atlas insurance management Whitehall House, 3rd Fl., 238 North Church St. George Town, Cayman Islands KY1-1107

Baker & Daniels P.O. Box 509 Yardley, PA 19067

Bartlett Actuarial Group, ltd. 145 King Street, Suite 203 Charleston, SC 29401

calmetto management Group, inc. 883 N.E. Main Street Simpsonville, SC 29681

camelback captive Services, inc. 15255 N. 40th Street, Suite 109 Phoenix, AZ 85032

capVisor Associates, llc P.O. Box 693 Chatham, NJ 07928

caring communities A Reciprocal RRG 1850 W. Winchester Road, Ste. 109 Libertyville, IL 60048

cBiZ mHm 3 Bethesda Metro Center, Suite 600 Bethesda, MD 20814

chartis insurance management Services 30 Main Street, Suite 330 Burlington, VT 05401

chelsea Rhone, llc 201 S. Main Street, #200 Ann Arbor, MI 48104

comerica Bank 411 W. Lafayette Blvd., MC 3331 Detroit, MI 48226

epmG 2000 Green Road, Suite 300 Ann Arbor, MI 48105

General motors 300 Rennaissance Center, MC#482-C19-C36 Detroit, MI 48265

Global international insurance co., inc. RRG 407 McAlpine Street Avoca, PA 18641

Government entities mutual, inc. 46 Donovan Street, Ste. 1 Concord, NH 03301

GpW & Associates, inc. 2700 N. 3rd Street, Suite 3050 Phoenix, AZ 85004

Great American insurance company 49 E. Fourth Street, Suite 700 Cincinnati, OH 45202

Health care casualty, RRG 3510 Whiteheaven Pkwy., NW Washington, DC 20007

Heartland Fidelity insurance co. 3131 Princeton Pike Bldg. 2B, Ste. 103 Lawrenceville, NJ 08648

intercorp, inc. 1438-F West Main Street Ephrata, PA 17522-1345

Johnson lambert & co. 3110 Fairview Park Drive, Ste. 800 Falls Church, VA 22042

Kane (uSA). inc. P.O. Box 247 Millwood, NY 10546

law offices of Douglas R. Holmes Three Pointe Drive, Suite 302 Brea, CA 92821

lionheart insurance management 601 Pennsylvania Ave., N.W., Ste. 900S Washington, DC 20004-2625

m.R. mead & company, inc. 400 N. Michigan Ave., Suite 1616 Chicago, IL 60611

maple technologies, llc 500 Craig Road, 2nd Floor Manalapan, NJ 07726

marcum llp 10 Melville Park Road Melville, NY 11747

marsh 100 Bank Street, Suite 610 Burlington, VT 05402-0530

mcDermott, Will & emery 227 West Monroe Street, Suite 4700 Chicago, IL 60606

mcKenna, long & Aldrige, llp 1900 K Street, N.W., Suite 100 Washington, DC 20006

medStar Health, inc. 5565 Sternett Place, 5th Floor Columbia, MD 21044

merlinos & Associates, inc. 3274-B Medlock Bridge Road Norcross, GA 30092

milliman, inc. 289 Edgewater Drive Wakefield, MA 01880

morris, manning & martin, llp 1333 H Street, NW, Suite 820 Washington, DC 20005

nASW Assurance Services 50 Citizens Way, Suite 304 Frederick, MD 21701

new Home Warranty ins. co., A Risk Retention Group 10375 E Harvard Ave, Suite 100 Denver, CO 80231

ober, Kaler, Grimes & Shriver, p.c. 1401 H Street, N.W., Suite 500 Washington, DC 20005-3324

ocean Risk Retention Group 837 Kearny Ave. Kearny, NJ 07032

pinnacle Actuarial Resources, inc. 8600 W. Bryn Mawr, Suite 410N Chicago, IL 60631

Page 13: Annual Domicile Report - Council of the District of Columbia · AnnuAl Domicile RepoRt 3 “We had a choice on where to domicile our risk retention group and selected DC based on

AnnuAl Domicile RepoRt 13

port Authority insurance captive entity, llc 225 Park Ave. South, 12th Floor New York, NY 10003

premium Financing Specialists P.O. Box 220 Puyallup, WA 98371

preservation insurance pcc, llc 1225 Johnson Ferry Road, Ste. 200 Marietta, GA 30068

Rcm&D 555 Fairmount Ave. Baltimore, MD 21286

Re-Solutions intermediaries, llc 10 South 5th Street, Suite 580 Minneapolis, MN 55402

Risk Services, llc 2233 Wisconsin Ave., N.W., Ste. 310 Washington, DC 20007

Saslow, lufkin & Buggy, llp 10 Tower Lane Avon, CT 06001

Sedgwick cmS 6377 Emerald Parkway Dublin, OH 43016

Select providers ins. Reciprocal exchange, an RRG 1631 Rock Springs Road, Suite 201 Apopka, FL 32712

Shawncoulson, llp 1850 M Street, NW, Suite 280 Washington, DC 20036-5804

SiGmA Actuarial consulting Group, inc. 5301 Virginia Way, Suite 230 Brentwood, TN 37027

Spring consulting Group, llc 84 State Street, Suite 500 Boston, MA 02109

Strategic Risk Solutions 1333 H Street NW, Suite 820 Washington, DC 20005

Subaru of America, inc. P.O. Box 6000 Cherry Hill, NJ 08034

towers Watson 901 North Glebe Road Arlington, VA 22203

trinity Risk Solutions Reciprocal ins. co., a RRG 225 Smith Road c/o IPMG St. Charles, IL 60174

ullico 8403 Colesville Road Silver Spring, MD 20910

Wells Fargo insurance Services 1753 Pinnacle Drive, 8th Floor McLean, VA 22102

Wiley & Rein, llp 1776 K Street, N.W. Washington, DC 20006

At Merlinos & Associates, our goal is to provide our clients with expert solutions to their most challenging risk and insurance problems. We are proactive in understanding our clients’ business and take a genuine interest in their future. As one of the largest independent P&C actuarial consulting firms, we combine the responsiveness, accessibility, and attentiveness of smaller firms with a breadth and depth of experience that rivals firms of any size. Our clients often have unique circumstances and our experience in working with them has given us a diverse array of experience with almost all property & casualty risks. merlinosinc.com 770.453.9771

Page 14: Annual Domicile Report - Council of the District of Columbia · AnnuAl Domicile RepoRt 3 “We had a choice on where to domicile our risk retention group and selected DC based on

membership applicationMEMBERSHIP APPLICATION

800.302.4232www.dccaptives.org

CIC-DC is an industry organization focused on promoting Washington, DC as a preferred domicile for captive insurance companies, including risk retention groups. Founded in 2001, the organization now has a large membership base and is extremely active in helping its members in the District.

Please print or type

Company/Association: ______________________________________________________________________________________________

Address: ________________________________________________________________________________________________________

City, State, Zip: ___________________________________________________________________________________________________

Telephone: ________________________________________________ Fax: _________________________________________________

Email: ____________________________________________________ Website: ______________________________________________

Full Name of Corporate Representative: __________________________________________________________________________________

Title: ___________________________________________________________________________________________________________

Primary Industry of Applicant: _________________________________________________________________________________________

SELECT MEMBERSHIP CATEGORY (Please check one only)

❑ Captive Insurance Company (Corporate or Association)* . . . . . . . . . . $500 .00

❑ If Formed by Non-Profit Entity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $350 .00

❑ Industry Service Provider . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $750 .00

❑ Affiliate** . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $400 .00* Also includes captive insurance programs in formation.

** Wholly-owned subsidiary of captive insurance company or industry service provider.

PAYMENT INFORMATIONTotal Amount Due $______________________________

❑ Enclosed is my check made payable to CIC-DC in US funds . OR ❑ Please charge the following:

❑ Visa ❑ Mastercard ❑ American Express ❑ Discover

Credit Card Number: _______________________________________________________________________________________________

Card in the Name of: _______________________________________________________________________________________________

Exp . Date: __________/__________ Val Code: ______________________ (MC/VISA/Discover - 3 digits on card back – Amex - 4 digits on card front)

Billing Address: ___________________________________________________________________________________________________

City, State, Zip: ___________________________________________________________________________________________________

Authorized Signature: __________________________________________________________________ Date: _______/_______/_______

TYPE OF BUSINESS (Please check one only)

❑ Single Parent Captive Program . . . . . . . . . . . . . . . . . . . . . . . . 01

❑ Association Sponsored Captive Program . . . . . . . . . . . . . . . . 02

❑ Risk Retention Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 03

❑ Industry Service Provider . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 04

❑ Press/Government . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 05

❑ Other _____________________ . . . . . . . . . . . . . . . . . . . . 06

4EASYWAYS

TO JOIN

MAIL: CIC-DC | 1250 H Street, NW | Suite 901 | Washington, DC 20005FAX: 202.463.8155 PHONE: 888.302.4232 ONLINE: www.dccaptives.org

Membership in CIC-DC is not tax-deductible as a charitable contribution for federal income tax purposes. However, membership dues and related payments made to CIC-DC may be deductible as an ordinary and necessary business expense.

Milliman provides new insights into the risks in today’s insurance environment. We are a leading provider of actuarial and management consulting services to captives and risk financing organizations worldwide. We bring depth, clarity, and context to the issues and challenges that our clients face every day.

Take advantage of our more than 60 years of expertise with enterprise risk management, loss and expense liabilities, risk retention alternatives, pricing and funding, financial modeling, claims management, and underwriting consulting.

For more information on what Milliman can do for you, please contact Joel Chansky at [email protected] or Mike Meehan at [email protected].

milliman.com/captives

A clear view of the risks ahead.

Page 15: Annual Domicile Report - Council of the District of Columbia · AnnuAl Domicile RepoRt 3 “We had a choice on where to domicile our risk retention group and selected DC based on

15 AnnuAl Domicile RepoRt

membership applicationMEMBERSHIP APPLICATION

800.302.4232www.dccaptives.org

CIC-DC is an industry organization focused on promoting Washington, DC as a preferred domicile for captive insurance companies, including risk retention groups. Founded in 2001, the organization now has a large membership base and is extremely active in helping its members in the District.

Please print or type

Company/Association: ______________________________________________________________________________________________

Address: ________________________________________________________________________________________________________

City, State, Zip: ___________________________________________________________________________________________________

Telephone: ________________________________________________ Fax: _________________________________________________

Email: ____________________________________________________ Website: ______________________________________________

Full Name of Corporate Representative: __________________________________________________________________________________

Title: ___________________________________________________________________________________________________________

Primary Industry of Applicant: _________________________________________________________________________________________

SELECT MEMBERSHIP CATEGORY (Please check one only)

❑ Captive Insurance Company (Corporate or Association)* . . . . . . . . . . $500 .00

❑ If Formed by Non-Profit Entity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $350 .00

❑ Industry Service Provider . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $750 .00

❑ Affiliate** . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $400 .00* Also includes captive insurance programs in formation.

** Wholly-owned subsidiary of captive insurance company or industry service provider.

PAYMENT INFORMATIONTotal Amount Due $______________________________

❑ Enclosed is my check made payable to CIC-DC in US funds . OR ❑ Please charge the following:

❑ Visa ❑ Mastercard ❑ American Express ❑ Discover

Credit Card Number: _______________________________________________________________________________________________

Card in the Name of: _______________________________________________________________________________________________

Exp . Date: __________/__________ Val Code: ______________________ (MC/VISA/Discover - 3 digits on card back – Amex - 4 digits on card front)

Billing Address: ___________________________________________________________________________________________________

City, State, Zip: ___________________________________________________________________________________________________

Authorized Signature: __________________________________________________________________ Date: _______/_______/_______

TYPE OF BUSINESS (Please check one only)

❑ Single Parent Captive Program . . . . . . . . . . . . . . . . . . . . . . . . 01

❑ Association Sponsored Captive Program . . . . . . . . . . . . . . . . 02

❑ Risk Retention Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 03

❑ Industry Service Provider . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 04

❑ Press/Government . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 05

❑ Other _____________________ . . . . . . . . . . . . . . . . . . . . 06

4EASYWAYS

TO JOIN

MAIL: CIC-DC | 1250 H Street, NW | Suite 901 | Washington, DC 20005FAX: 202.463.8155 PHONE: 888.302.4232 ONLINE: www.dccaptives.org

Membership in CIC-DC is not tax-deductible as a charitable contribution for federal income tax purposes. However, membership dues and related payments made to CIC-DC may be deductible as an ordinary and necessary business expense.

Milliman provides new insights into the risks in today’s insurance environment. We are a leading provider of actuarial and management consulting services to captives and risk financing organizations worldwide. We bring depth, clarity, and context to the issues and challenges that our clients face every day.

Take advantage of our more than 60 years of expertise with enterprise risk management, loss and expense liabilities, risk retention alternatives, pricing and funding, financial modeling, claims management, and underwriting consulting.

For more information on what Milliman can do for you, please contact Joel Chansky at [email protected] or Mike Meehan at [email protected].

milliman.com/captives

A clear view of the risks ahead.

Page 16: Annual Domicile Report - Council of the District of Columbia · AnnuAl Domicile RepoRt 3 “We had a choice on where to domicile our risk retention group and selected DC based on

FaegreBD.com

For nearly three decades, Baker & Daniels has delivered practical, knowledgeable, efficient and responsive service to the captive industry. Our recent combination with Faegre & Benson brings our lawyers and consultants into a single firm with more than 800 professionals serving clients from 13 offices in the United States, United Kingdom and China.

The firm name has changed, but our dedication to the captive industry has not. With the additional expertise of our Faegre colleagues, our team continues to understand your business and focus on the complex issues facing the captive world.

Thoughtful, focused, value driven.

New Name.Same Captive Focus.


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